Epidemiology of stroke and its subtypes in Chinese vs white populations: a systematic review.

Abstract

OBJECTIVE:

We aimed to systematically assess the evidence for differences in the incidence of stroke and distribution of its subtypes in Chinese compared with white populations.

METHODS:

We comprehensively sought studies conducted since 1990 in Chinese populations of 1) first-ever stroke incidence (community-based studies only), and 2) pathologic types/subtypes of stroke (hospital- or community-based studies of first-ever or recurrent strokes). We identified community-based studies in white populations from a recent systematic review. For each study, we calculated age-standardized stroke incidence and the proportions of each pathologic type and ischemic subtype, using random-effects meta-analysis to pool proportions of stroke types/subtypes in Chinese and in white populations.

CONCLUSIONS:

There is good evidence for a slightly higher overall stroke incidence and higher proportion of intracerebral hemorrhage in Chinese vs white populations, but no clear evidence for different distributions of ischemic stroke subtypes. Studies using comparable, population-based case ascertainment and similar classification methods are needed to address this.

Age-standardized incidence (per 100,000 person-years) for (A) ages 45–74 years and (B) ages 45–75+ years. Confidence interval could not be calculated in one study because the number of strokes in each age-specific group was not available.e3